Individual
JACQUELINE MARIE STOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 729-3300
(907) 729-8607
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262
(907) 729-6351
(907) 729-8607
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
R41453
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9406716
FL
Other
Enumeration date
10/16/2008
Last updated
06/08/2022
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